Relationship between family-related factors and functional constipation among Chinese preschoolers: a case–control study

Abstract

Background Constipation is one of the common symptoms in childhood. The prevalence of FC is about 0.5% to 32% and still on the rise according to global statistics. The aim of this study is to explore the associations between family-related factors (e.g., parental conflict, parenting style, and parent–child relationship) and functional constipation of preschool children based on family system theory. Methods The study is a case–control survey of preschoolers in China. In total, 108 preschoolers with functional constipation diagnosed with pediatric Rome IV criteria and 324 healthy examination preschoolers without functional constipation were enrolled in the study. Parents completed the following 5 instruments: General information questionnaire, the Parental Conflict Scale, the Parenting Style Questionnaire, the Child-parent Relationship Scale and the Children’s Emotional Adjustment Scale-Preschool Version. Results Nine categories of factors which significantly predicted functional constipation in preschoolers were retained in the final logistic regression model: Second child in birth order (OR = 0.456; 95% CI, 0.229 to 0.910), children picky eating (OR = 2.936; 95% CI, 1.133 to 7.611), bad bowel habits (OR = 2.896; 95% CI, 1.391 to 6.028), parental history of constipation (OR = 3.259; 95% CI, 1.600 to 6.639), parents blaming the child for having a bad bowel movement (OR = 3.788; 95% CI, 1.391 to 10.318), more than 3 h of fathers-child interaction time per day (OR = 0.137; 95% CI, 0.024 to 0.778), parental conflict (OR = 1.981; 95% CI, 0.950 to 3.831), doting or authoritarian parenting style (OR = 1.644; 95% CI, 1.067 to 2.534, OR = 2.481; 95% CI, 1.362 to 4.519), and anxiety control or temper control in children (OR = 0.492; 95% CI, 0.303 to 0.799, OR = 0.189; 95% CI, 0.103 to 0.348). Conclusions This study identified the significant associations between family-related factors and functional constipation in preschool children, which provide implications for healthcare professionals to address functional constipation in early childhood using a preventive lens.

Constipation: A Pristine Universal Pediatric Health Delinquent

“…Globally, FC in children is on the rise [19,30,31]. Worldwide, its prevalence ranges from 0.5% to 32.2% (Figure 2) [30,[32][33][34][35][36].…”

“…One study from China found that, through multiple logistic regression model analyses, nine features precipitated FC. Those are second child in birth order, children's picky eating, bad bowel habits, parental history of constipation, parents blaming the child for having a bad bowel movement, more than three hours of father-child interaction time per day, parental conflict, doting or authoritarian parenting style, and anxiety control or temper control in children [31]. However, no specific gene could be identified conclusively that may contribute to its pathophysiology [112].…”

“…Parents' discouraging attitude toward the development of autonomy in children decreases human internal motivation [114]. This lack of motivation causes an excessive psychological burden, raising the chance of FC [31,87]. In the present world, mental stress is a global phenomenon that results in constipation [115].…”

“…It impacts children, family members, caregivers, and medical professionals [11,31,138,139]. Reduced stool frequency causes fecal incontinence (FI) [140], anal fissures [141], recurrent urinary tract infections (RUTI) [142], and enuresis in children [143].…”

State of the Art Bowel Management for Pediatric Colorectal Problems: Functional Constipation

“…The child-parent relationship is another important factor affecting the outcomes. Niu et al emphasized the importance of family communication where the parents blaming a child for having accidents, a conflict between the parents, an authoritarian or doting parenting style, anxiety or temper control in children, and anxiety or depression in the parents predicted the development of constipation in children of preschool age [57,58]. Poor bowel habits and the child's picky eating are also associated with an increased risk of FC [58].…”